continued on page 36

Urologists add no-contact testing 
layer to patient care.

I

n late April, the son of one of 
Dr. Howard Korman’
s patients 
called his urology office to 
describe symptoms of a recurring 
condition that in the past had 
been treated with medication.
“I dreaded thinking that in the 
midst of the COVID situation 
I would be taking my almost 
92-year-old dad from his home in 
Chesterfield all the way to Royal 
Oak and have him go inside a 
doctor’
s office,
” said his son, who 
asked to remain anonymous. “We 

knew the doctor would want to 
do a urinalysis, and were very 
pleasantly surprised to learn that 
he could make arrangements for 
my dad to be treated without 
leaving his house.
”
After a telemedicine videocon-
ference, Dr. Korman included his 
patient in what he described as “a 
grassroots urine specimen home 
pickup method” provided by 
Comprehensive Urology, a group 
of 50 urologists and advanced 
practice providers, of which 

Korman is president.
As a urologist, he said most of 
his patients require urine testing 
to diagnose possible conditions, 
some of which, if left untreated, 
could be life-threatening. “We 
had many patients who were 
afraid to come to the office,
” 
Korman said. “But the problem 
was, how else do we get urine to 
check for blood, protein, glucose 
or signs of infection?”
In response to the chal-
lenge, Korman, along with 
Comprehensive Urology pathol-
ogist Dr. Rajan Dewar and Issam 
Atoussi, the group’
s COO, created 
a way for patients to provide 
urine samples without leaving 
their homes and with limited or 
no contact with another person.

DROP OFF AND PICK UP
After a urinalysis is ordered, 
patients are contacted by Mai 
Her, a medical assistant and tech-
nical trainer for Comprehensive 
Urology’
s lab who also serves as 
the office dispatcher. She then 
arranges for a courier to drop off 
a urine sample kit on the patient’
s 
front porch. “They are so appre-
ciative that they don’
t have to 
come into the office when they 
don’
t feel well and are concerned 
about COVID,
” Her said. 
In some cases, the courier 
would wait in their car in front 
of the patient’
s home until the 
specimen was placed outside. 
“If they needed more time, 
the driver would leave and 
the patient would call when 
they were ready and I would 
arrange for the courier to go 
back, usually within 12-24 
hours,” Her said. 
At the start of the COVID 
shutdown, four drivers were 
making a total of 40 daily trips 
to patients’
 homes, with Her 
mapping out stops including 
those in Novi, West Bloomfield, 
Bloomfield Hills, Dearborn, Troy, 
Southfield, Oak Park, Grosse 
Pointe, Macomb, Birmingham, 
Royal Oak and Rochester. 
Now about 75% of the group’
s 

patients are booking appoint-
ments in their CDC guide-
line-adherent offices with appro-
priate PPE and social distancing. 
Home drop offs and pick-
ups are down to about 10 daily, 
with only one individual, Dr. 
Korman’
s son Jonathan, continu-
ing as a courier, having driven as 
far as 200 miles in a day.
“Samples are picked up with-
in 30 minutes of the time they 
are placed outside, and I pro-
cess them immediately in the 
Comprehensive Urology lab,” 
said Jonathan Korman, who is 
also working as a laboratory 
technician. 
“From time to time, I get 
to talk to the patients from a 
distance, wearing gloves and a 
face mask.”
A dipstick analysis is per-
formed on each sample by 
an automated machine, with 
results immediately sent to the 
ordering physician.
“We are also using an inno-
vative kind of urine culture 
from Pathnostics using PCR 
techniques which analyze the 
DNA of the bacteria in the 
urine to yield identities and 
sensitivities of bacteria much 
faster than a conventional 
urine culture,” Dr. Korman 
said. “This enhances our ideal 
of a fast turnaround time for 
results.”

STAYING SAFE
Until the COVID-19 outbreak, 
Dr. Korman primarily saw 
patients in his Royal Oak and 
Farmington Hills offices. By 
April 1, like others in the health-
care sector, he needed to find 
a way to continue to treat his 
patients while keeping them — 
and his staff — safe. He reduced 
in-office appointments to the 
10% with emergency needs. 
The rest were seen by tele-
medicine. “But analyzing urine 
is a critical part of the checkup 
for urologists,” Korman said. 
“The new program allows us 
to add that to our no-contact 

34 | JULY 30 • 2020 

Front Porch 
Medicine

SHELLI LIEBMAN DORFMAN CONTRIBUTING WRITER

Dr. Howard Korman and Issam 
Atoussi in the Royal Oak 
Comprehensive Urology office.

Health